1. Accuracy and Reliability of the Ankle Brachial Index Measurement Using a Multicuff Oscillometric Device Versus the Doppler Method
- Author
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Shigeo Ichihashi, Julien Magne, Victor Aboyans, Tomoko Hashimoto, Ileana Desormais, Kimihiko Kichikawa, Nara medical University, Kashihara, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CCSD, Accord Elsevier, Clinical sciences, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Ankle Brachial Index/instrumentation ,Male ,Intraclass correlation ,030204 cardiovascular system & hematology ,030230 surgery ,0302 clinical medicine ,Japan ,Positive predicative value ,Prospective Studies ,Aged, 80 and over ,Observer Variation ,Equipment Design ,Middle Aged ,3. Good health ,medicine.anatomical_structure ,Peripheral Arterial Disease/diagnosis ,Lower Extremity ,Cuff ,cardiovascular system ,Female ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Lower Extremity/blood supply ,Concordance ,Asymptomatic ,03 medical and health sciences ,Predictive Value of Tests ,Oscillometry ,Peripheral arterial disease ,medicine ,Oscillometry/instrumentation ,Humans ,cardiovascular diseases ,Ankle brachial index ,Aged ,Reproducibility ,business.industry ,Reproducibility of Results ,Ultrasonography, Doppler ,Atherosclerosis ,Confidence interval ,body regions ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Surgery ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Ankle ,Nuclear medicine ,business ,human activities - Abstract
International audience; Objective: Ankle brachial index (ABI) is widely used for the diagnosis of lower extremity artery disease (LEAD). The purpose of this prospective study was to validate the diagnostic ability and reproducibility of a four cuff automated oscillometric device vs. the Doppler method. Methods: Patients with suspected LEAD or asymptomatic individuals at risk because of the presence two or more cardiovascular risk factors were enrolled. For each patient, Doppler and oscillometric ABI measurements were repeated by two observers to address intra- and interobserver reproducibility. Results: In total, 118 patients were evaluated. The prevalence of Doppler ABI (Dop-ABI) ≤ 0.90 was 45.8%. Taking the Dop-ABI as the reference, the sensitivity, specificity, accuracy, positive and negative predictive values of oscillometric ABI (Osc-ABI) during the first measurement by the first observer were 89.1%, 94.4%, 94.1%, 91.8%, and 92.4%, respectively. The concordance for diagnosing ABI ≤0.90 between methods was excellent (kappa coefficients ranging from 0.80 to 0.88 with different observers). Intra-observer reproducibility assessed by intraclass correlation coefficient (ICC) between methods were 0.94 for observer 1 and 0.96 for observer 2. The intra-observer reproducibility using the same method was also excellent (ICC 0.94, 95% confidence interval [CI] 0.91-0.95) for Dop-ABI and 0.95 (95% CI 0.93-0.97) for Osc-ABI). The ICC for interobserver reproducibility using the same method was 0.95 (95% CI 0.92-0.96) for Dop-ABI and 0.96 (95% CI 0.94-0.97) for Osc-ABI. Conclusion: This study validates the excellent diagnostic performances of a four cuff oscillometric device specifically designed for screening for LEAD. The simple measurement method could therefore be advocated in primary care where fast, easy, and reliable methods are suitable.
- Published
- 2020